AMY MEREDITH BLACKBURN MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125056736

License Status

CANCELLED

Business

First Name

AMY

Middle

MEREDITH

Last Name

BLACKBURN

Suffix

Business Name

AMY MEREDITH BLACKBURN MD

Original Issue Date

07/01/2009

Effective Date

07/01/2009

Expiration Date

06/30/2012

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Emergency Medicine

Ever Disciplined

LastModifiedDate

05/15/2009